At this weekend's annual ADA Conference, I had the
privilege to sit for an hour just chewing the fat (or, um, chatting...)
about the state of diabetes care with Dr. Richard Jackson of the Joslin Diabetes Center.
Dr. Jackson has the dubious title of "Director ofField Outreach, Strategic Initiatives," but his personal passion is talkingwith patients about how diabetes affects their life.
For new patients, his biggest edict is, "You arenot doomed. People with diabetes are doing better and better all thetime."
"When patients come in I ask, 'How are you doing?'Often they slump down in their seats and say, 'I don't know.' So I say, 'NO,how are you doing?'" he told me.
The point is: How do you feel? Physically?Mentally? The only way to achieve well-being isto be in touch with your own state of affairs, this doctor says.
Here are Dr. Jackson's top tips for getting ahandle on your own diabetes and getting the most out of your doctor/educator visits, as herelated them to me this week:
* Find Out Where You AreStartout by getting your numbers: your A1C (at least every 3 months), and your blood pressure, cholesterol, and microalbumin testresults (all annually). Also, make sure you see an opthamologist annually to be armed withthe data on your eye health. Never go in to see your diabetes doctor without knowingwhat your health starting point is, Jackson says, or the visit will be unproductive.And don't get caught up on some stringent number-goals. Some people do quite well with A1C's of 7+, or even up to 9, he says.
* Decide What to Focus OnIt isridiculous to think you have to tackle everything at once. Look at your health records, and decide which ONE or TWO things youwill work on in the coming months.
Instead of making vague resolutions like, "I'll eatbetter," focus on very specific things like lowering your A1C by checking moreoften so that you can react immediately to highs.
Or maybe you'll focus on blood pressure instead ofthe diabetes-specific stuff. "If a Type 2 gets his/her blood pressure down from 150 to140, they can gain as much health-wise as by lowering their A1C," the doctorsays.
* Thinkof Your Diabetes as a Small Business, and Your Care Team as YourConsultantsGo in to your appointments with information on whereyour "business" stands, and clear goals and/or questions. Have them advise you onthese specifics to get the most "bang for your buck." And remember that these people workfor you. Sometimes you might want an A1C more often than every 3 months. If theypush back, insist.
"If you ask, your doctor will likely do it. Youjust have to ask!" Jackson says. (He also notes that Metrika's home A1C testing kit
for under $20 at the drugstore is a goodoption.)
* Make Sure You See theResultsThis is why you need regular testing. Get your older andnewer test results side-by-side and compare your numbers. You can seethat you have made a difference!
Reward yourself in some positive way, and then setnew goals for your next triumph. The ability to see the difference you have made iskey. It's a rush, like improving your SAT scores or video game scores -- whateverturns you on.
If you do all this, there's no way for nastycomplications to sneak up on you, Jackson says. You'll be on top of it and won't allowproblems to progress. "Remember, nothing ever happens suddenly withdiabetes."
Thank you, Dr. Jack, I feel betteralready!